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From the 6/4/2021 release of VAERS data:

Found 323,133 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 185 out of 3,232

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VAERS ID: 1286215 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 020A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Diarrhoea, Dyspnoea, Headache, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Nausea, Pain, Sleep disorder, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccines
Other Medications: Vitamin D3, Calcium, Magnesium, Zinc, Elderberry liquid
Current Illness: none
Preexisting Conditions: Asthma
Allergies: erythromycin, Etodlac
Diagnostic Lab Data: none
CDC Split Type:

Write-up: the night of 4/30/21 started to get a slight fever of 100.5. at 2:00am on 5/1/21 i woke straight up with bodyaches, fever of 102.8, headache, nausea, vomited x 3 times, SOB, diarrhea, chills which all lasted till sunday 5/2/21. on 5/2/21 the area of the injection started to itchy, be painful and the become red and swollen with heat, the injection site to this day on 5/4/21 the redness of the site getting bigger and itching and painful more and going up my left shoulder area.


VAERS ID: 1286257 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dose of Moderna administered to 16 year old


VAERS ID: 1286426 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-05-01
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Pain, Pain in extremity, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain 3 weeks post vaccine. Initial arm pain faded after 4 days. New pain started after 19 days. Hurts to lift or put pressure on the left arm at all. Getting worse by the day. Pain is directly at vaccination site and slightly below. Was told by doctor to come back in if I develop a fever and take ibuprofen in the meantime.


VAERS ID: 1286499 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-19
Onset:2021-05-01
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Computerised tomogram, Pulmonary thrombosis, X-ray
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Chromium Picolinate
Current Illness: Migraines , Degenerative Disc Disease, Fibromyalgia, Hypothyroidism, Acid Reflux , Low GFR 50
Preexisting Conditions: Degenerative Disc Disease, fibromyalgia
Allergies: Tape, Macrodantin, Pyridium
Diagnostic Lab Data: Cat scan, numerous blood tests Xrays All done on 5/1, 5/2 and 5/3. Patient was placed on a heparin drip then release to go home with Xarelto.
CDC Split Type:

Write-up: May 1, 2021, Patient was admitted to the hospital with Blood clots in both lungs. The hospital is unable to figure out what has caused the blood clots. We do not know if this is related to the vaccine but would like to know if it is.


VAERS ID: 1286560 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Nausea, Product administered to patient of inappropriate age
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was 17.83 yrs of age at time of vaccine administration; not 18 years. Pt was choosen to prevent a wasted dose; pt also employee of pharmacy as a delivery driver. Pt''s father also employee of pharmacy who had a heart transplant last year. Pt had nausea about 12 hours after shot; only lasted about 12 hours. By 24 hours after shot no remaining issues other than pain at injection site.


VAERS ID: 1286647 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood culture negative, Blood glucose normal, Blood lactic acid normal, Confusional state, Differential white blood cell count, Full blood count, Haematocrit decreased, Haemoglobin increased, Hypertension, Liver function test normal, Metabolic function test normal, Neutropenia, Platelet count decreased, Pyrexia, Red blood cell count decreased, SARS-CoV-2 test negative, Tachycardia, Thrombocytopenia, Troponin normal, Urine analysis normal, White blood cell count decreased
SMQs:, Agranulocytosis (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: Covid-19 Moderna, 4/3, 71 years old, he experienced confusion and fever that lasted one day
Other Medications: Tylenol and Motrin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 5/1: POC glucose-110; CBC and differential-WBC 4.13, RBC 3.97, Hemoglobin 11.4, Hematocrit 34.4, platelets 125; basic metabolic panel- normal; hepatic function panel- normal; blood cultures-no growth; troponin-normal; lactic acid- normal; covid test-negative; urinalysis-normal
CDC Split Type:

Write-up: A few hours after the vaccine he experienced acute confusion, a fever of 103.8 degrees F, tachycardia, hypertension, neutropenia, and thrombocytopenia. He was given Tylenol, placed ice packs under arms and neck, normal saline, and ceftriaxone. He has been hospitalized for the past 4 days.


VAERS ID: 1286676 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-16
Onset:2021-05-01
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / UNK UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis, Computerised tomogram head
SMQs:, Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Skin Eczema
Allergies: NKDA
Diagnostic Lab Data: CT head
CDC Split Type:

Write-up: Venous sinus thrombosis


VAERS ID: 1287069 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hyperhidrosis, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Type 2 Diabetes, High Blood Pressure
Allergies: None
Diagnostic Lab Data: Didn''t seek medical assistance yet.
CDC Split Type:

Write-up: First sign was a headache and nausea. Several hours later, I received chills, sweats and body aches for two days. One the second day, in the late evening I had a fever of 101, The chills, sweats and body aches continued, On the third day, I started feeling better, but very tired.


VAERS ID: 1287635 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: none listed
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Moderna vaccine was administered to a patient under 18 years of age. No reported side effects or adverse reactions at this time.


VAERS ID: 1287831 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-28
Onset:2021-05-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain lower, Computerised tomogram abdomen abnormal, Renal infarct, Urogram
SMQs:, Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Renovascular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D Vitamin B12
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 5/1/21 - CT abdomen 5/2/21 - CT urogram
CDC Split Type:

Write-up: Onset of severe LLQ abdominal pain 10am 5/1/21. By 5pm same day, decided to seek emergency services. Went to ER. Diagnosed with kidney infarction


VAERS ID: 1287843 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-26
Onset:2021-05-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fluid replacement, Transfusion, Uterine dilation and curettage, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Humilin N (insulin)
Current Illness: None
Preexisting Conditions: Type 2 diabetes
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaginal blood hemorrhaging started at 4am. Admitted to ER. Severe bleeding and passing of large blood clots. Required an emergency D&C and a blood transfusion, plus fluids.


VAERS ID: 1287932 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Myalgia, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Iodine allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210501582

Write-up: THROAT PAIN; MUSCLE PAIN; FATIGUE; This spontaneous report received from a patient concerned a 53 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included iodine allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042a21a and expiry: 01-MAY-2021) dose was not reported, administered on 01-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-MAY-2021, the subject experienced muscle pain. On 01-MAY-2021, the subject experienced fatigue. On 02-MAY-2021, the subject experienced throat pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fatigue, and muscle pain, and had not recovered from throat pain. This report was non-serious.


VAERS ID: 1287950 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210502604

Write-up: DIARRHEA; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 29-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 01-MAY-2021, the subject experienced diarrhea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from diarrhea. This report was non-serious.


VAERS ID: 1287952 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210501; Test Name: Body temperature; Result Unstructured Data: 37.9 C
CDC Split Type: USJNJFOC20210502666

Write-up: 10 ITCHY RED DOT/MODERATE ITCHY FEELING; FEVER AT 37.9C; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 01-MAY-2021, the subject experienced 10 itchy red dot/moderate itchy feeling. On 01-MAY-2021, the subject experienced fever at 37.9c. Laboratory data included: Body temperature (NR: not provided) 37.9 C. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever at 37.9c and 10 itchy red dot/moderate itchy feeling was not reported. This report was non-serious.


VAERS ID: 1287963 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Axillary pain, Discomfort, Hypoaesthesia, Limb discomfort, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503260

Write-up: PRESSURE; ARM WAS A LITTLE NUMB; SORE AROUND ARM PIT; SORE ON LEFT ARM; FEEL LIKE BLOOD PRESSURE CUFF IN LEFT ARM; This spontaneous report received from a patient concerned a 54 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, expiry: UNKNOWN) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-MAY-2021, the subject experienced pressure. On 01-MAY-2021, the subject experienced arm was a little numb. On 01-MAY-2021, the subject experienced sore around arm pit. On 01-MAY-2021, the subject experienced sore on left arm. On 01-MAY-2021, the subject experienced feel like blood pressure cuff in left arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feel like blood pressure cuff in left arm, pressure, sore on left arm, arm was a little numb, and sore around arm pit. This report was non-serious.


VAERS ID: 1287965 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Migraine
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503353

Write-up: HEADACHE; This spontaneous report received from a parent concerned a 19 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included migraine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 01-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On MAY-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of headache was not reported. This report was non-serious.


VAERS ID: 1288032 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenopia, Chills, Pyrexia, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Corneal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210504000

Write-up: RUNNY NOSE; EYES HEAVY; CHILLS; FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 01-MAY-2021, the subject experienced runny nose. On 01-MAY-2021, the subject experienced eyes heavy. On 01-MAY-2021, the subject experienced chills. On 01-MAY-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the runny nose, fever, chills and eyes heavy was not reported. This report was non-serious.


VAERS ID: 1288038 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Deafness, Deafness neurosensory, Deafness unilateral, Ear discomfort, Pain in extremity, Tinnitus
SMQs:, Hearing impairment (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I had taken Lasix, 20 mg for 2 days prior to vaccination
Current Illness:
Preexisting Conditions: Fibromyalgia and hypertension
Allergies: sulfa
Diagnostic Lab Data: Audiology test and pressure test. 5/3/2021, confirmed 100% loss of hearing in right ear. No fluid, no obstruction. Idiopathic Sensory Hearing Loss.
CDC Split Type:

Write-up: I had my Covid Pfizer vaccine on 4/30 in the morning and only felt a mildly sore arm that evening. I woke up the next morning to very stuffed ears, high pitched ringing in my ears...It was difficult to hear over the loud tone in my head/ears., My hearing declined Throughout the day by night time I have no hearing left in my right ear. I went to see my ENT specialist on Monday, 5/1/2021. I had a full audiology work up and meeting with my ENT. The exam so that I had 100% hearing loss in my right ear. I am having an MRI on Weds 5/12 and meeting again with my ENT on 5/18. I was put on a high dose of steroids, Prednisone, for the next 2 weeks. trying to get back some hearing.


VAERS ID: 1288050 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Hot flush, Lymph node pain
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin, Flonase, nature''s bounty women''s multivitamins, zinc, turmeric
Current Illness: N/A
Preexisting Conditions: Was born with ventricular septal defect (hole in heart) - closed on its own in infancy
Allergies: Sulfa drugs
Diagnostic Lab Data: N/A - did not seek medical care as it appeared the issue has been reported as a reaction by others
CDC Split Type:

Write-up: Armpit pain (lymph nodes?): Armpit very painful and tender on the left side (vaccine was injected in left arm). Pain was only in that associated armpit. Pain lasted from 5/1/21 to 5/4/21 about the same time of day (noon). Only other symptoms were hot flashes in the 2 days after receiving the vaccine. Felt fine for a day then the armpit pain started. It seems to be mostly gone by the one week mark. Only a faint hint of soreness remains at this time. I am a 38 year old female, not using hormonal birth control, reproductive organs are still functional/intact, no abnormal menstrual cycles prior to vaccine. No issues with cycle to report at this time.


VAERS ID: 1288063 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-05-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / SC

Administered by: Other       Purchased by: ?
Symptoms: Immediate post-injection reaction, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trulicity Metformin Atenolol Protonix Losartan Montelukast
Current Illness: Chronic conditions
Preexisting Conditions: Diabetes type 2 Asthma Hypertension PVCs
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling and itching surrounding area immediately after vaccine was given. Swelling, increased redness, pain, itching days later. Noticed that injection site from Trulicity (stomach, subQ) is substantially more swollen and itchy, red, painful, for an extended period of time. This happens post COVID vaccine. No relief from Benadryl or other measures.


VAERS ID: 1288339 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-28
Onset:2021-05-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rybelsus, Synjardy
Current Illness: none
Preexisting Conditions: Asthma, diabetes, PCOS
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: My last menstrual cycle was 4/14. It is a regular cycle. My next cycle came just 2 days after I received the Vaccine dose and was a heavier and more painful cycle than normal.


VAERS ID: 1288471 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-19
Onset:2021-05-01
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Lymphadenopathy, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First dose 3/23 swollen painful breasts and joints
Other Medications: N/a
Current Illness: N/a
Preexisting Conditions: IBS
Allergies: Erythromycin adhesive tape
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Swollen painful arm pit right arm pain in both arms/joints elbow to wrist


VAERS ID: 1288472 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Headache, Neck pain
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experiencing headaches, neck pain, and back pain.


VAERS ID: 1288525 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Dysstasia, Headache, Limb discomfort, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Cigarette smoker (1 pack a day); Irritable bowel syndrome
Preexisting Conditions: Medical History/Concurrent Conditions: Back pain; Comments: The patient was not pregnant at the time of report.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210502747

Write-up: UNABLE TO STAND UP; HEAVINESS IN BOTH LEGS; PAIN IN LEFT UPPER THIGH; HEADACHE; BACK ACHE; This spontaneous report received from a patient concerned a 45 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included back pain, and concurrent conditions included irritable bowel syndrome (ibsd) with major constipation, abstains alcohol, and cigarette smoker, and other pre-existing medical conditions included the patient was not pregnant at the time of report. The patient experienced cannot breath when treated with tetanus vaccine for prophylactic vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: UNKNOWN) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, the subject experienced back ache, pain in left upper thigh, headache. On 01-MAY-2021 and heaviness in both legs. On 02-MAY-2021, the subject experienced unable to stand up. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from heaviness in both legs, headache, pain in left upper thigh, back ache, and unable to stand up. This report was non-serious.


VAERS ID: 1288648 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503826

Write-up: STOMACH DISCOMFORT; WEAKNESS; LIGHTHEADED; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 01-MAY-2021, the subject experienced lightheaded. On 01-MAY-2021, the subject experienced weakness. On 03-MAY-2021, the subject experienced stomach discomfort. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from lightheaded, and had not recovered from weakness, and stomach discomfort. This report was non-serious.


VAERS ID: 1288679 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210506535

Write-up: VOMITING; BODY ACHES; NAUSEA; FEVER; HEADACHE; FATIGUE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On MAY-2021, the subject experienced vomiting. On MAY-2021, the subject experienced body aches. On MAY-2021, the subject experienced nausea. On MAY-2021, the subject experienced fever. On MAY-2021, the subject experienced headache. On MAY-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from vomiting, nausea, fever, and headache on MAY-2021, and had not recovered from fatigue, and body aches. This report was non-serious.


VAERS ID: 1288706 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site vesicles, Lymphadenopathy, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever and full body joint pain lasting a full week (and worsening before getting better) after first COVID vaccine dose on 4/6/2
Other Medications: Vitamin D
Current Illness:
Preexisting Conditions: mild, well controlled asthma
Allergies: Pineapple; sulfa antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling and severe itching on injection arm; blistering around injection site; redness. Pain radiating down arm and up neck. Swollen painful lymph nodes under arms and in neck (worse on side of injection) Treatment: benedryl and tylenol/advil. significant swelling and itching, blistering and lymph node swelling resolved on 5/42021. Minor itching and radiating pain continue, but are lessened by advil/tylenol and benedryl.


VAERS ID: 1288759 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-10
Onset:2021-05-01
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 31 y.o. female admitted on 5/1/2021 Please refer to the History and Physical report for information on presentation. 31-year-old female with no significant past medical history was admitted to the hospital due to left-sided flank pain radiating to the groin. CAT scan abdomen pelvis was done which showed 3 mm obstructing ureteric calculi leading to left-sided hydronephrosis. Additional nonobstructing stones of both kidneys were also noted. Patient was started on Flomax for pain management. UA was also grossly positive, patient was started on ceftriaxone. Urology was consulted, recommended stent placement if patient unable to pass stone. However patient was able to pass stone within 24 hours. Patient will be discharged home on Ceftin to complete 7 days course. Blood sugars were also noted to be elevated during her hospital course. A1c not back at the time of discharge. Patient was instructed to follow-up with her PCP, for results of A1c, and up titration of medication. Patient will be discharged on 500 mg Metformin. Patient understands the plan


VAERS ID: 1288760 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-28
Onset:2021-05-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reported a buzzing in the ears that has been constant started 3 days after shot in the morning on 5/1/2021 and has not stopped since. She called today to report (5/5/2021) and it has not stopped she is currently still experience non stop tinnitus, pharmacist recommended visiting her physician to follow up.


VAERS ID: 1288877 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Headache, Neck pain, Pain
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Exedrine Migraine
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache starting that day lasting 3 days. Severe upper back/lower neck pain as well as shoulder blade. I can barley even move my head without pain.


VAERS ID: 1288882 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Fatigue, Injection site rash, Pain, Pyrexia, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, sprintec birth control.
Current Illness:
Preexisting Conditions:
Allergies: Peanuts, soybeans, sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 1: exhaustion Day 2: sore body, fevers (high of 102.4), exhaustion, chills, hot red ?rash? on arm (under injection shot) Day 3: mild fevers (high of 99.7), sore body Day 4: hives (treated with Benadryl)


VAERS ID: 1288935 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Fatigue, Muscle spasms, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed a fever, reaching 101 degrees on Saturday (2nd dose of vaccine on Friday PM). Was also nauseous and fatigued, but I?m in the first trimester (8 weeks + 2 days at time of vaccine). Also had some cramping, but no spotting. Estimated due date is 12/8/21.


VAERS ID: 1288959 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-05-01
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Thrombosis, Vaccination complication
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine on 4/10/21. Went to ED, got IV placed due to side effects. Came to clinic on 5/4/21 with right arm pain. Found to have occlusive cephalic vein clot.


VAERS ID: 1289064 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Chest pain, Dyspnoea, Full blood count, Influenza like illness, Lipase, Metabolic function test, Prothrombin time, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: none
Preexisting Conditions:
Allergies: no known allergies
Diagnostic Lab Data: Comp. panel, CBC, Lipase, Prothrombin time/INR, partial thromboplastin time
CDC Split Type:

Write-up: Patient developed adverse reaction like fever, flu like symptoms and rashes on the first day post vaccine second dose (05/01/2021) and then she went to ER morning of 05/04/2021 at about 1 am due to chest pain and SOB


VAERS ID: 1289224 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-13
Onset:2021-05-01
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Fall, Head injury, Hypersomnia, Muscular weakness, Somnolence, White matter lesion
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 71 y.o. female admitted on 5/1/2021 due to falls. Please refer to the History and Physical report for information on presentation Patient was admitted to the hospital due to recent multiple falls and hitting her head. Patient family brought her in, reported that she has been very drowsy lately, she barely comes down to eat dinner. She sleeps most of the time. She has been compliant with all her medications. All imaging studies showed no acute findings. Including CAT scan head which showed chronic white matter changes, but no acute finding. Neurology evaluated patient, they have done extensive work-up in the past to rule out falls including lumbar puncture, MRI,eeg However all the testing has been negative. Patient''s vitals remained stable. Patient states she just feels her legs gives up. PT eval the patient, recommended rehab. Patient will be discharged to rehab. Patient''s medications were also titrated down to decrease drowsiness. Patient remained AAO x3 during hospital stay.


VAERS ID: 1289318 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Dyspnoea, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: COPD, hyperlipidemia, tobacco use
Allergies: flexeril, wellbutrin
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache, diarrhea, myalgia, shortness of breath


VAERS ID: 1289422 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-24
Onset:2021-05-01
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute coronary syndrome, Acute myocardial infarction, Angiogram abnormal, Anticoagulant therapy, Coronary arterial stent insertion, Coronary artery stenosis, Percutaneous coronary intervention
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 71 yr. old male admitted for Hospital (non-ST elevated myocardial infarction) [I21.4], ACS (acute coronary syndrome) [I24.9, Please refer to the History and Physical report for information on presentation. The patient was admitted. He ruled in for myocardial infarction and cardiology was consulted. He was started on beta-blocker and statin and aspirin and anticoagulated. Subsequently he was taken for angiography. The following results were found: Right dominant coronary anatomy. Left main-0%. LAD-mid 90% stenosis with plaque extending up to the diagonal bifurcation. Distal 30% narrowing. TIMI-3 flow. D1-small with proximal 40% narrowing. D2-medium size vessel with mid 30% narrowing. Circumflex-proximal 30% supplying a large branching OM. OM1-luminal irregularities up with up to mid 20% narrowing. RCA-dominant vessel with slight luminal irregularity distally. Right PDA-20% narrowing proximally. Right PLB-30% narrowing proximally. The patient underwent PCI with stent to the LAD and transferred to the floor. I discussed him with Dr. who recommended discharge to home this afternoon. ACE inhibitor


VAERS ID: 1289434 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-27
Onset:2021-05-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrioventricular block, Chest pain, Electrocardiogram normal, Heart rate decreased, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 89 y.o. male admitted on 5/1/2021 Please refer to the History and Physical report for information on presentation. 89-year-old male with past medical history of CAD, recent cath done in January, known disease that is not amenable to intervention, hypertension, BPH, diabetes mellitus came to ED due to chest pain. Patient had persistent chest pain despite nitroglycerin, however later reports relieved. Troponin negative initially, however later trended up. EKG unchanged. Patient became asymptomatic during hospitalization. Cardiologist Dr. evaluated patient, recommended no further management except for blood pressure control. Blood pressure medications were adjusted. Cardiologist said patient has known CAD, that is not amenable to any intervention. He will have underlying some chest pain and troponin leak. Patient needs to fllow up with cardiologist in the office. He has known AV node block. Sometimes heart rate went down to as low as 30. Patient remained asymptomatic. Lopressor dose was decreased from 50 mg to 25 mg daily. Amlodipine dose increased. Patient understands, and agrees for discharge. Plan explained to family, wife present at bedside. All the concerns were answered.


VAERS ID: 1289448 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-19
Onset:2021-05-01
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Chest X-ray normal, Condition aggravated, Electrocardiogram abnormal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: HPI: This is 69 years old man with extensive cardiac history including coronary disease status post CABG in 1995, stable from that standpoint with recent negative stress test. The patient also has a history of A. fib for which he is on Xarelto. He was on Lopressor for years and complained to his primary care provider that he had a rectal dysfunction so this was discontinued on Thursday and he was started on Norvasc. He went to a bar to wash therapy with friends and after he had to severe he started feeling dizzy heaviness in the head and blurry vision. He denies having any chest pain, shortness of breath, headache, focal weakness numbness tingling. He has had no palpitation. He got concerned so he came to the emergency room. He had no symptoms in the ER. EKG showed atrial fibrillation with nonspecific ST-T change. Chest x-ray showed no acute intracranial abnormality.


VAERS ID: 1289463 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-26
Onset:2021-05-01
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bilevel positive airway pressure, Continuous positive airway pressure, Cough, Dyspnoea, Hypoxia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: HPI: Patient is a 79 y.o. male who presents with the chief complaint of progressively worsening of shortness of breath associated with cough and fever which has a started 2 days ago. Patient states that he has been otherwise in his usual state of health. In the past he used to use oxygen supplement therapy at home but he has not been using any oxygen recently since his respiratory condition had improved. Patient has followed up by pulmonary consult as an outpatient but he has not seen any physician recently. By the time EMS arrived at home patient was noticed to be hypoxic and started on CPAP. On the way in the hospital hospital but he had 2. Patient on nonrebreather mask and in the ER patient was initially started on BiPAP ventilation which was switched to Patient denies any loss of consciousness no nausea vomiting abdominal pain no diarrhea no constipation. Patient denies any coffee-ground vomiting no rectal bleeding no flank pain no hematuria no dysuria no frequent urination.


VAERS ID: 1289504 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-29
Onset:2021-05-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Herpes zoster, Rash, Rash erythematous, Rash papular, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, ASA, Eliquis, Lasix, Gabapentin, Geritussin, Lactulose, Levemir, Methenamine Hippurate, Novolog, Omeprazole, ProAir HFA, Phenazopyridine, Spirolactone, Sucralfate, Ultram, Valacyclovir HCL, VHC calorie supplement, Vit D3, Xifaxan,
Current Illness: No acute illness
Preexisting Conditions: Type 2 Diabetes, Obesity, Hyperlipidemia, Vascular Dementia with behavioral disturbances, Major depression disorder, Panic disorder, Essential HTN, Hypertensive heart disease with heart failure, Obstructive hypertrophic cardiomyopathy, A-fib, Heart failure, COPD, GERD, Hepatic failure, non-alcoholic stetohepatitis, muscle weakness, syncopy and collapse, Past hx Covid -19 ( 12/20)
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Resident developed Herpes Zoster, red raised, blisters neck and shoulder and hairline areas. Currently being treated VALCYCLOVIR.


VAERS ID: 1289510 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient falsified DOB when registering for vaccination. Guardian consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB made the vaccine a contraindication. No known adverse reactions noted.


VAERS ID: 1289522 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient falsified DOB when registering for vaccination, stating the minor was. Guardian, consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB is which made the vaccine a contraindication. No known adverse reactions noted.


VAERS ID: 1289523 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient falsified DOB when registering for vaccination. Guardian consented to the vaccination. Department of Health verified with statistical records that the patients actual DOB made the vaccine a contraindication. No known adverse reactions noted.


VAERS ID: 1289534 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-11
Onset:2021-05-01
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Breast pain, Computerised tomogram thorax abnormal, Electrocardiogram, Musculoskeletal chest pain, Pulmonary embolism, Ultrasound scan
SMQs:, Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Lipodystrophy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Progesterone, thyroid, multi-vitamin, HRT
Current Illness:
Preexisting Conditions: high cholesterol
Allergies: N/A
Diagnostic Lab Data: Can upload a report = 48 pages CAT scan revealed bloods clots
CDC Split Type:

Write-up: extreme pain, left side from back to ribs and breast. Went to ER on 5/3/21, had EKG, CAT, ultrasounds, etc. Diagnosis = bi-lateral pulmonary embolism. TX = Eloquis for next 30 days.


VAERS ID: 1289595 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse event. Patient outside of age range.


VAERS ID: 1289766 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-16
Onset:2021-05-01
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: OCP
Current Illness: none
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: CT scan
CDC Split Type:

Write-up: pulmonary embolism


VAERS ID: 1289965 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-04
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Headache, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin c Centrum
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Around 630, I started getting a headache. My arm was sore. By 7, I was itchy all over, around 10, I started getting a tight feeling around my chest whish lasted several hours.


VAERS ID: 1290046 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-08
Onset:2021-05-01
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1805022 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nortrel 7/7/7 (oral contraceptive) Xalatan ophthalmic drops Cosopt ophthalmic drops Multivitamin Omega 3-DHA
Current Illness: Drug induced glaucoma
Preexisting Conditions: Overweight (BMI 34)
Allergies: Sertraline Cocoa butter
Diagnostic Lab Data: Venous Duplex
CDC Split Type:

Write-up: Left lower leg DVT


VAERS ID: 1290134 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-28
Onset:2021-05-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: Moderna Covid Vaccine on 3/31/21
Other Medications: Cholecalciferol 25 Mcg (VITAMIN D3 25 MCG) 25 Mcg Tablet, 1 TAB PO DAILY Multivitamin (Centrum Complete Multivit Tab) 1 Each Tablet, 1 TAB PO DAILY Glucosamine Hcl (Glucosamine Hcl) 500 Mg Tablet, 1500 MG PO DAILY Omega-3 Fatty Acids/Fish O
Current Illness:
Preexisting Conditions: atrial fibrillation (post cryoablation in 2018), hypertension, chronic shoulder pain, melanoma s/p surgery 9/2018, osteoarthritis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt admitted complaining of palpitations and admitted for afib with RVR. Pt started on diltiazem drip and metoprolol. Pt converted to normal sinus rhythm after 16 hours of treatment with diltiazem drip. Pt was discharged within 24h of admission and sent home on metoprolol.


VAERS ID: 1290190 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-05-01
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding, Oral contraception
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loryna (oral contraceptive) Albuterol Breo Claritin D
Current Illness: N/A
Preexisting Conditions: asthma
Allergies: Lamictal (rash)
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: After receiving the vaccine on 4/8, my next menstrual period has been approximately twice as long as usual. I typically menstruate for 4 days, 5 maximum. This period began about a day earlier than usual on 4/27, and now 8 days later on 5/5, I am still seeing light spotting. My periods are very predictable because of the pill; when I was not on the pill, they were scant, only a few times a year. This includes periods of extreme stress. It is completely abnormal for me, historically and under any circumstances, to be menstruating this long. If it continues through the week, I will see my doctor. I want people to know that this is really happening to women, it is not a simple matter of spurious rumors spreading online.


VAERS ID: 1290301 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin ER 500 mg tab Metoprolol tart 50 mg tab Fludrocort 0.1 mg tab Levothyroxine 75 mcg Amlodipine 5 mg tab Glimepiride 2 mg tab Predinsone 5 mg
Current Illness: unknown
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received Johnson and Johnson vaccine on Saturday May 1st. I administered the vaccine. Today, 5/5 she came to the pharmacy to show me the circle rash that had developed around injection site. It was also swollen and felt like a bruise. I counseled patient on "covid arm" and that it was likely her immune system activating. I explained this can be a common reaction after getting the COVID vaccine. Patient had no other symptoms. I went over things to look out for in relation to blood clots and any warning signs and when to reach out to her doctor. I suggested she fill out Vsafe and I told her I would report to VAERS.


VAERS ID: 1290432 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-27
Onset:2021-05-01
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptom onset of 5/1/2021 with loss of taste, loss of smell & runny nose. Tested positive via PCR on 5/3/2021.


VAERS ID: 1290464 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-24
Onset:2021-05-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Eyelid oedema, Herpes virus test, Herpes zoster, Ocular hyperaemia, Pruritus, Staphylococcus test negative
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Valtrex and Doxycycline after a second opinion. Eerythromycin and Cephalexin were originally prescribed.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: MRSA- 5/5/2021 negative Herpes - 5/5/2021positive for Shingles
CDC Split Type:

Write-up: One week post vaccine, little blisters lower eyelid, itchy and swollen. Prescribed Erythromycin and Cephalexin. Next day, red eye, blisters worse, swollen and itchy. Second opinion, prescribed valtrex and doxycycline. Following day starting to improve. Day 4 just blisters now.


VAERS ID: 1290472 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-05-05
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna Vaccine administered to Patient who is still a minor. Pt monitored for 15 minutes, Pt reports no symptoms, no adverse reactions and is asymptomatic at the time of event.


VAERS ID: 1290625 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-03-01
Onset:2021-05-01
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Headache, Immune thrombocytopenia, Immunoglobulin therapy, Laboratory test abnormal, Magnetic resonance imaging head abnormal, Mouth haemorrhage, Petechiae, Platelet count decreased, Subdural haematoma
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: hyperthyroidism (uncontrolled), previous COVID-19 infection 12/20
Preexisting Conditions: hyperthyroidism (uncontrolled)
Allergies: n/a
Diagnostic Lab Data: CT/MRI brain (multiple), several labs results spanning two hospitalizations, etc
CDC Split Type:

Write-up: Pt is 25 yo female who received the first dose of the Pfizer COVID-19 vaccine in March 2021 developed diffuse petechiae and oral bleeding approximately 3 weeks after the vaccine and went to her PCP''s office and labwork revealed a platelet count of ~15k cells/mm3. She went to the emergency department at Medical Center and was diagnosed with ITP by a hematologist who recommended that she not receive the second covid vaccine given the risks outweigh the benefits with her new diagnosis/possible reaction to the vaccine. She was treated with IVIG and prescribed corticosteroids and discharged. Two weeks later she was visiting friends in another city and developed a severe headache. She presented to our facility and was found to have a subdural hematoma on imaging and a platelet count of 9k cells/mm3. She was aggressively treated for her ITP with high dose IVIG, romiplostim, and rituximab and has stabilized neurologically with the SDH stable - though her platelets have been treatment refractory despite transfusions and the aforementioned therapy. Remains admitted at our facility.


VAERS ID: 1290641 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-05-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Hypoglycaemia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Hypoglycaemia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tujeo insulin, humalog insulin
Current Illness: N/A
Preexisting Conditions: TPE 1 DIABETES
Allergies: codene
Diagnostic Lab Data: 5.1.2021 After receiving glucogon injection to raise my blood sugar by emergency crew & repeated blood glucose finger sticks at Emergency Room.
CDC Split Type:

Write-up: I had an extreme hypoglycemic episode within 48-hours of receiving the COVID-19 vaccine which resulted in my being transported to the hospital by ambulance.


VAERS ID: 1290693 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-05-01
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Mobility decreased, Pain in extremity, Peripheral swelling, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthoid, HCTZ, Enalapril, B12, MVI
Current Illness: None
Preexisting Conditions: HTN, Hypothyroidism
Allergies: None
Diagnostic Lab Data: Sent for Ultrasound of RT upper extremity
CDC Split Type:

Write-up: Severe swelling and pain at the RT arm with decrease ROM


VAERS ID: 1290695 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient walked in with his mother to receive a COVID-19 J&J vaccine on 5/1/2021 in the afternoon. The patient filled out the consent form and indicated his date of birth (16 years old). A Janssen vaccine was then administered and the patient was monitored for 15 minutes. The patient denied any signs or symptoms of complications and went home. On Monday morning, a pharmacy intern reviewed the consent forms to bill for the vaccines and noticed that the patient was not within the approved age range to receive the J&J vaccine and notified the pharmacy manager and the immunizing pharmacist. It was determined that there was an administration error, however, it was not associated with any adverse event(s).


VAERS ID: 1290738 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-01
Onset:2021-05-01
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram normal, Lymphoma
SMQs:, Malignant lymphomas (narrow), Haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PLAVAX
Current Illness:
Preexisting Conditions: TRIPLE BYPASS IN JUNE OF 2020
Allergies:
Diagnostic Lab Data: CAT Scan
CDC Split Type:

Write-up: My father had a triple bypass in June of 2020 and then in October of 2020 had a stent. He had his chest wide open in June and then CAT scan in October and clean scan, after stent. Then he gets the vaccine in March of 2021 and then two days ago was diagnosed with Lymphoma. I think there is a correlation. My father also was diagnosed and treated in 2017 for STAGE 1 bladder cancer. No chemo or radiation, just surgery and clean bill of health. I think the vaccine may have "woken up" cancer cells? I don''t know. But it makes no sense to me. I begged him not to get the vaccine until it was FDA approved.


VAERS ID: 1291282 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-29
Onset:2021-05-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNK / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Cardiac monitoring, Chest discomfort, Chest pain, Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR 25 mg/day
Current Illness: None
Preexisting Conditions: ADHD
Allergies: None
Diagnostic Lab Data: Holter monitor portable electrocardiogram initiated week of 10-MAY-2021. Results TBD.
CDC Split Type:

Write-up: Chest pain/discomfort, Heart Palpitations/Abnormal Heart rhythm, Shortness of breath, Exhaustion, Lightheadedness and dizziness. Symptoms are ongoing and of intermittent intensity. Aspirin daily for chest pain. See below for diagnostic tests ordered.


VAERS ID: 1291285 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is 15 and received the Pfizer COVID vaccine


VAERS ID: 1291355 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-29
Onset:2021-05-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Hypoaesthesia, Injection site pain, Injection site swelling
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Left shoulder pain
Allergies: Sulfates
Diagnostic Lab Data:
CDC Split Type:

Write-up: My face went numb for several hours a day and a half after injection. I also had extreme fatigue, headaches, and pain and swelling at the injection site for 7+ days.


VAERS ID: 1291434 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-14
Onset:2021-05-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back disorder, Chills, Fatigue, Feeling abnormal, Loss of personal independence in daily activities, Pain in extremity, Sleep disorder
SMQs:, Dementia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, lisinopril htz, oxybutynin, nephedipine, cbd oil, tumeric, megared krill oil, multivitamin, claritin, azo cranberry, D-3, ezetimibe, miralax
Current Illness:
Preexisting Conditions: Type 2 diabetes Hypertension Psoriasis Inflammation Asthma IBS Psoriatic arthritis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Started saturday May 1st with the basic "vaccine arm" pain... Today is wednesday May 5 and It STILL hurts really bad. Nothing with injection site, no other side effects... I did have severe arm pain on day 2 of 2nd dose along with chills, fatigue and brain fog which all subsided on day 3... This pain in my arm is JUST like the pain i had with the 2nd dose... I couldnt have slept on it wrong because i sleep on my right side and this is my left arm and i have a bad back so i know for certain that i didnt over exhurt myself because i literally am very limited to what i can do physically. I have no other explanation for this pain and the vaccine is the only thing i can think of since it mirrors the same exact pain... But why so much later??? Maybe you guys know?


VAERS ID: 1291439 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Myalgia, Nausea, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dextroamphetamine 20mg daily, Escitalopram 10mg daily
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea at 10:00pm day of injection Day 2: fever 100?, cough, muscle aches, chills, painful arm Day 3: lingering cough, muscle aches, chills, painful arm Day 4: fatigue, lingering muscle aches & arm pain Day 5: fatigue, lingering muscle aches & arm pain


VAERS ID: 1291446 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Headache, Musculoskeletal discomfort, Night sweats
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: D 5000mg per day im deficient, mens multi vit, OTC allergy medication
Current Illness: none
Preexisting Conditions: had high bloof pressure, in check now.
Allergies: none
Diagnostic Lab Data: none.. just got the shot
CDC Split Type: not known

Write-up: major headache for three days, first night felt like there were hot electrodes zapping through my hand joints these were severe enough to bring tears to my eyes. night sweats for three nights with 102 temp. shoulder joints, knee joints and left hip joint were also affected


VAERS ID: 1291462 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0176 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Muscle spasms, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Going in for an appointment next week with doctor.
CDC Split Type:

Write-up: My adverse symptoms began less than an hour after the injection. It began with tingling feelings in my right foot. About a half an hour later I began having pain and cramping in my right foot as well. The cramping seemed to come and go in spurts. It was not constant pain. But it kept coming back in the form of cramps. This would continue into the late evening and early morning. I would have to walk around and up and down stairs to get it to calm down in intensity. It also came back in terms of cramping on the following day. It''s now still with me 4 days after the vaccine.But usually only in the mornings and evenings. Today cramping started when I walked a ways towards the store from the parking lot. I''m wondering when it will stop.


VAERS ID: 1291485 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-29
Onset:2021-05-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have developed a full-body itchy rash. It has spread slowly from my legs 1 day after the vaccine. It has spread from my legs to my arms then my chest and then my face.


VAERS ID: 1291524 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-18
Onset:2021-05-01
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Ocular hyperaemia, Seasonal allergy, Sneezing
SMQs:, Anaphylactic reaction (narrow), Glaucoma (broad), Conjunctival disorders (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I developed seasonal allergies for the first time ever Headache, redness in the eyes, sneezing and fatigue almost 10 days after the second dose of vaccine


VAERS ID: 1291589 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: Body temperature; Result Unstructured Data: 102, Unit not reported
CDC Split Type: USJNJFOC20210504194

Write-up: 102 FEVER; ACHE; CHILLS; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On MAY-2021, the subject experienced ache. On MAY-2021, the subject experienced chills. On MAY-2021, the subject experienced 102 fever. Laboratory data included: Body temperature (NR: not provided) 102 Unit not reported. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the 102 fever, chills and ache was not reported. This report was non-serious.


VAERS ID: 1291593 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dysmenorrhoea, Headache, Muscle spasms
SMQs:, Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210504718

Write-up: PERIOD AWFUL; HORRIBLE CRAMPS; HEADACHE; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 2021 for prophylactic vaccination. No concomitant medications were reported. The batch number was not reported. Per procedure, no follow-up will be requested for this case. On MAY-2021, the subject experienced period awful. On MAY-2021, the subject experienced horrible cramps. On MAY-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the period awful, horrible cramps and headache was not reported. This report was non-serious.


VAERS ID: 1291819 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Injection site pain, Pain, Spinal pain, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Medium, Systemic: Abdominal Pain-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Fainting / Unresponsive-Mild, Additional Details: constant pain down spine (midback to lower back).


VAERS ID: 1291904 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-15
Onset:2021-05-01
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Blindness unilateral, Retinal vein occlusion
SMQs:, Embolic and thrombotic events, venous (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: sertraline 100 mg daily, for anxiety
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: diagnosis: Central Retinal Vein Occlusion
CDC Split Type:

Write-up: Loss of site in the left eye. Went to my regular eye doctor, then to retina specialist


VAERS ID: 1291910 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardiac disorder, Cardiac stress test normal, Echocardiogram normal, Electrocardiogram normal, Fall, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allupirinol, 300 mg. Vitamin B-12, Vitamin D-3, Ibuprofen infrequently. None taken that day.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Many, many ekgs over May 1-$g May 3 (normal) Exercise stress test May 3. Very good. Echocardiogram May 5. Normal
CDC Split Type:

Write-up: I had the vaccination (my second) and waited the required 15 minutes after the injection. I felt fine and got on my bike and road home. I took a longer route (10 miles), and I remember things up to almost the end. The bike ride ended with a bad fall, I presumably had a syncopal event and crashed my bicycle. Bad hit on helmet, and I was unconscious for probably five minutes. I was found and woken up by a passerby (I have no memory of this) and then the EMTs arrived. Checked into Emergency Room. They suspected a cardiac event, but I have so far passed all the tests (exercise stress test, echocardiogram, normal QT). I have *never* had an event like this, the bike ride, while a little long, was quite normal for me. I also note that I had possibly not had enough to eat or drink that morning. So, based on the curious timing of this event, I personally believe it''s related to the shot. I also don''t really believe this is an anxiety related syncopal event (it was more than an hour after the shot), but rather I suspect an immune response, perhaps aggravated by dehydration/lack of enough food. But who knows? I was out cold, and don''t remember the minute or so up to the crash. I did go back to inspect the bikeway that I was on to see if there was anything there that could have caused a crash (tree branches, rough surface) and I found nothing. It was a pretty flat easy bike path at that point.


VAERS ID: 1291958 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Computerised tomogram normal, Confusional state, Electrocardiogram normal, Fall, Fatigue, Headache, Nausea, Night sweats, Pain, Pyrexia, Seizure
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 60mg Duloxetine
Current Illness: HSP
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: May 5th, 2021 Tests Conducted: CT scan (normal) Glucose test (normal) EKG (normal)
CDC Split Type:

Write-up: About 10-15 hours after injection - Came down with headache, fever, body aches, fatigue, and night sweats. Recovered fully 24 hours after injection. May 5th, 2021 ~7:30 am (4 days post-vaccination) I stood up from a seated position and then collapsed moments later and had, what my brother described as, a seizure which was followed by confusion, nausea, and fatigue.


VAERS ID: 1292220 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-05
Onset:2021-05-01
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: blood pressure meds, vitamin c, d3, quercetin, zinc, etc
Current Illness:
Preexisting Conditions: high blood pressure, hypothyroid
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Almost 3 1/2 weeks later broke out all over with red body rash. It is very itchy. Took two benedryl just now.


VAERS ID: 1292270 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Aortic dissection, Chest pain, Computerised tomogram head normal, Computerised tomogram thorax normal, Myocarditis, Neck pain, Pain in extremity, Troponin increased
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: Troponin 2.5 on presentation CT aortic dissection negative CT head negative
CDC Split Type:

Write-up: A few hours after 2nd dose of vaccine started having pain to entire left side of body including left arm, left chest, left neck, left leg. Presented to the ED 2 days later for her symptoms. Found to have elevated troponin consistent with NSTEMI vs. myocarditis.


VAERS ID: 1292574 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-23
Onset:2021-05-01
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NA / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NA / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Chills, Cough, Dizziness, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client was feeling generally weak, off balance and chilled starting on 5/1. Subsequently, he developed body aches and a non productive cough. He has no sore throat, chest pain, or shortness of breath. On 5/4 the client presented to the emergency department with generalized weakness, lightheadedness, chills, cough, and fever. He received Tylenol and IV fluids while in the ER. Covid test was negative. Client admitted to hospital for further evaluation.


VAERS ID: 1292609 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin
Current Illness:
Preexisting Conditions: DM
Allergies: NA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: At 1238 pt stood up c/o dizziness. Pt. refused to sit down for 3-5 min. After pt sat down, CFD took @1243 BP 99/65, HR 95. Pt drinking Gatorade, states he was diabetic and hadn''t eaten today. At 1247 BP 97/60, HR 94. At 1249 HR 94, BP 103/68, BS 147 Pt states he was feeling better and wanted to go home. Pt left @ 1252. BS 147, BP 103/68


VAERS ID: 1292638 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Cardiovascular evaluation, Chest discomfort, Chest pain, Myocarditis, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Obesity
Allergies: None
Diagnostic Lab Data: troponins: 05/04/2021 - 8.9 ng/mL, 05/05/2021 - 19/9 ng/mL.
CDC Split Type:

Write-up: Patient received COVID-19 vaccination (Moderna) on 04/30/2021 from a store pharmacy. Patient presented to the Emergency Department on 05/04/2021 with a chief complaint of chest pain. Patient informed the care team that he began feeling intermittent, non-exertional chest discomfort on 05/01/2021. Patient was then evaluated by the inpatient cardiologist due to concern for a myocardial infarction. The patient had a troponin of 8.9 ng/mL that climbed to 19.9 ng/mL the next day. Patient was ultimately diagnosed with Myopericarditis and initiated on treatment with carvedilol and colchicine.


VAERS ID: 1293086 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aldolase, Angiotensin converting enzyme, Anti-aquaporin-4 antibody, Anti-cyclic citrullinated peptide antibody, Antinuclear antibody positive, Asthenia, Blood copper normal, Blood creatine phosphokinase normal, Blood folate normal, Blood glucose decreased, Blood zinc normal, Borrelia test, C-reactive protein increased, CSF cell count increased, Computerised tomogram head abnormal, Cryptococcus test, Fungal test, Gait inability, Gram stain negative, HTLV test, Herpes simplex test negative, Intervertebral disc degeneration, Magnetic resonance imaging spinal abnormal, Myalgia, Protein total decreased, Red blood cell sedimentation rate normal, Rheumatoid factor, Spinal osteoarthritis, Spinal stenosis, Treponema test negative, Vertebral foraminal stenosis, Vitamin B12 normal, White blood cell count
SMQs:, Rhabdomyolysis/myopathy (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Divalproex, estrace cream, Bupropion, Olanzapine, Levothyroxine
Current Illness: None
Preexisting Conditions: Chronic Kidney Disease, schizoaffective disorder, leg lymphedema, hypothyroidism
Allergies: None
Diagnostic Lab Data: Creatinine Kinase 5/2 - 5069, 5/2 - 4170, 5/3 - 3350, 5/4 - 1254 Labs collected 5/3: Myositis Antibody Panel - in process B12 743 B9 9.9 RF <10 Anti-CCP <3 ANA <1:80 ESR 3 CRP 9.2 Labs collected 5/4: Aldolase - in process Zinc 52 Copper 91 CSF studies Cell Count 90% lymphocytes Glucose 46 Protein 27 Gram stain WBC''s, no organism Culture no growth Negative for: VDRL, HSV, Cocci, Cryptococcus, HTLV Pending: Aquaporin 4 receptor IGG, MS panel, ACE, fungal culture, varicella zoster, borrelia burgdorferi CT Head 5/2/21 IMPRESSION: No CT evidence of acute intracranial process. Mild chronic senescent changes. MRI Cervical Spine 5/4/21 IMPRESSION: Examination is significantly degraded and limited by motion artifacts. Patient unable to hold still. Within this limitation, no definite cord abnormalities are detected. Focal signal changes/pathology can be obscured. Degenerative changes in the cervical spine as detailed above at individual levels. MRI Lumbar Spine 5/5/21 IMPRESSION: Multilevel mild degenerative disc disease with minimal central canal stenosis and mild bilateral neural foraminal stenosis at L3-4. Additional details as above.
CDC Split Type:

Write-up: Patient received vaccination midday on 4/30, had mild generalized myalgias on 5/1, by evening of 5/2 had generalized weakness of all extremities causing her to be unable to ambulate was found down on the floor. Admitted to the hospital on 5/1 and transferred to our medical center on 5/2 with persistent weakness. Physical exam concerning for possible transverse myelitis versus myositis versus vaccine reaction with 4/5 strength in all 4 extremities


VAERS ID: 1293177 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-05
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UJ493AA / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Unknown, attempted to call parent, number has been disconnected


VAERS ID: 1293843 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness postural, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness upon standing, sweating for 15 minutes after 15 minutes observation while sitting


VAERS ID: 1294007 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Dyspnoea, Fatigue, Mental impairment, Night sweats, Pain, Painful respiration, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: Body temperature; Result Unstructured Data: 100.5; Test Date: 20210502; Test Name: Body temperature; Result Unstructured Data: 99
CDC Split Type: USJNJFOC20210502600

Write-up: DIFFICULTY THINKING; SHORTNESS OF BREATH; PAINFUL BREATH; FEVER; BODY ACHES; CHILLS; EXHAUSTION; NIGHT SWEATS; This spontaneous report received from a patient concerned a patient of unspecified age, sex, race and ethnicity. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, 1 total administered on 01-MAY-2021 12:45 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 01-MAY-2021 approximately 16:00, the patient experienced fever, difficulty thinking, shortness of breath, painful breath, body aches, chills, exhaustion to the point of falling asleep in the middle of tasks and night sweats. On MAY-2021, Laboratory data included: Body temperature (NR: not provided) 100.5 F. On 02-MAY-2021, Laboratory data included: Body temperature (NR: not provided) 99 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, and body aches, and the outcome of difficulty thinking, shortness of breath, painful breath, chills, exhaustion and night sweats was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0;20210502600-Covid vaccine coad26.cov2.s-Difficulty thinking, shortness of breath, painful breath. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1294009 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503173

Write-up: FLU-LIKE SYMPTOMS; ACHE; FEVER; HEADACHE; This spontaneous report received from a consumer concerned a 53 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 01-MAY-2021 to Left Arm for prophylactic vaccination. No concomitant medications were reported. On 01-MAY-2021, the subject experienced flu-like symptoms. On 01-MAY-2021, the subject experienced ache. On 01-MAY-2021, the subject experienced fever. On 01-MAY-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from flu-like symptoms, ache, fever, and headache. This report was non-serious.


VAERS ID: 1294026 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210501; Test Name: COVID-19 PCR test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210505084

Write-up: CONFIRMED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 31 year old male. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 28-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 01-MAY-2021, the subject experienced confirmed covid-19 infection. Laboratory data included: COVID-19 PCR test (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from confirmed covid-19 infection. This report was non-serious.; Sender''s Comments: V0:As per standard protocol, No MAC comment is required for non serious case


VAERS ID: 1294037 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210506561

Write-up: BODY ACHE; CHILLS; FEVER; HEADACHE; NAUSEA; This spontaneous report received from a patient concerned a 58 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 204A21A, expiry: UNKNOWN) dose was not reported, administered on 02-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, the subject experienced body ache. On MAY-2021, the subject experienced chills. On MAY-2021, the subject experienced fever. On MAY-2021, the subject experienced headache. On MAY-2021, the subject experienced nausea. The action taken with covid-19 vaccine was not applicable. The outcome of the fever, chills, headache, body ache and nausea was not reported. This report was non-serious.


VAERS ID: 1294087 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Headache, Lip swelling, Seizure
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210501; Test Name: spike body temperature; Test Result: Inconclusive ; Result Unstructured Data: temperature is not coming down, it is not going up, but it is also not coming down
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Seizure; Spike Body temperature; Swollen Lip; Headache; This spontaneous case was reported by a consumer and describes the occurrence of SEIZURE (Seizure) in a 40-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 30-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-May-2021, the patient experienced SEIZURE (Seizure) (seriousness criterion medically significant), BODY TEMPERATURE INCREASED (Spike Body temperature), LIP SWELLING (Swollen Lip) and HEADACHE (Headache). At the time of the report, SEIZURE (Seizure), BODY TEMPERATURE INCREASED (Spike Body temperature), LIP SWELLING (Swollen Lip) and HEADACHE (Headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-May-2021, Body temperature: inconclusive (Inconclusive) temperature is not coming down, it is not going up, but it is also not coming down. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication included paracetamol. Company Comment - Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1294091 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cellulitis, Vaccination site mass, Vaccination site pain, Vaccination site reaction, Vaccination site swelling, Vaccination site urticaria
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Cellulitis; arm was painful; COVID arm; raised bumps; hives; little bit of swelling / arm was very swollen; This spontaneous case was reported by a consumer and describes the occurrence of CELLULITIS (Cellulitis) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 01-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-May-2021, the patient experienced VACCINATION SITE REACTION (COVID arm), VACCINATION SITE MASS (raised bumps), VACCINATION SITE URTICARIA (hives) and VACCINATION SITE SWELLING (little bit of swelling / arm was very swollen). On 02-May-2021, the patient experienced CELLULITIS (Cellulitis) (seriousness criterion medically significant) and VACCINATION SITE PAIN (arm was painful). At the time of the report, CELLULITIS (Cellulitis), VACCINATION SITE REACTION (COVID arm), VACCINATION SITE MASS (raised bumps), VACCINATION SITE URTICARIA (hives), VACCINATION SITE SWELLING (little bit of swelling / arm was very swollen) and VACCINATION SITE PAIN (arm was painful) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication were reported. Treatment included antibiotics. As per reporter, the patient has not yet started therapy, at the time of report. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1294123 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206421A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Head discomfort, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Received vaccine in right arm
CDC Split Type:

Write-up: Pt states he has pressure behind the tear by temple, has been feeling nauseas, and has tinging in arm.


VAERS ID: 1294229 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-28
Onset:2021-05-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol, vyvanse, finasteride, cymbalta
Current Illness: None.
Preexisting Conditions:
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got shingles.


VAERS ID: 1294296 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-06
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 17 YEAR OLD PATIENT WAS ADMINISTERED MODERNA COVID-19 VACCINE IN ERROR


VAERS ID: 1294337 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vimpat, Onfi, Fycompa, Guanfacine
Current Illness: Epilepsy
Preexisting Conditions: Epilepsy
Allergies: Benadryl
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Multiple seizures that were not common with epilepsy. This occurred for a couple of days after the vaccine.


VAERS ID: 1294505 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Brain natriuretic peptide increased, Cardiac failure, Condition aggravated, Immediate post-injection reaction, Sepsis, White blood cell count increased
SMQs:, Cardiac failure (narrow), Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: diltiazem, clonidine, warfarin, allopurinol colchicine
Current Illness: none
Preexisting Conditions: Atrial fibrillation, CAD, history of DVT, skin cancer
Allergies: none
Diagnostic Lab Data: BNP 8000, WBC 18
CDC Split Type:

Write-up: Pt had covid19 in 11/2020, now with immediate onset of sepsis of unclear source after 1 dose Pfizer vaccine as well as rapid atrial fibrillation and heart failure


VAERS ID: 1294517 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-04-26
Onset:2021-05-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site reaction, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Hay fever, wool
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Mildly pruritic rash, 5cm, at injection site. Two applications of topical steroid (betamethasone) Resolved within four days.


VAERS ID: 1294655 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210507358

Write-up: CHILLS; HEADACHE; MUSCLE ACHES; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. Batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On MAY-2021, the subject experienced chills. On MAY-2021, the subject experienced headache. On MAY-2021, the subject experienced muscle aches. The action taken with covid-19 vaccine was not applicable. The outcome of the headache, chills and muscle aches was not reported. This report was non-serious.


VAERS ID: 1294754 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-28
Onset:2021-05-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pyrexia, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Not sure when it actually started, as I had fever like symptoms the day after, but ever since I have had a ringing in my ears. With background noise or doing some kind of activity it sufficiently distracts me from it but it''s quite clear in the morning and night. Hasn''t gotten better or worse.


VAERS ID: 1294766 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-05-01
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid
Current Illness: hypothroid
Preexisting Conditions: hypothroid
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: tinnitus in my left ear


VAERS ID: 1294780 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Disorientation, Fatigue, Feeling hot, Insomnia, Migraine, Neck pain, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo Loestrin Fe, Omeprazole
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Night after vaccine (4/30/2021 to 5/1/2021): had trouble sleeping despite being tired (atypical for me), felt overly warm (atypical for me) 5/1/2021, 8am: woke up feeling disoriented, fell back asleep 5/1/2021, 11:30am: woke up and could not fall back asleep, even though I still felt tired. Felt very overheated, had migraine headache, felt sore in hips, knees, and neck. Treated migraine with 2 tablets of 220mg naproxen sodium. Fell back asleep around 12:15pm and slept till 2:30pm. Felt better when I woke up. 5/1/2021, 6:00pm: headache returned, felt drowsy. Napped for approximately 1hr 45min. Woke up and headache was still bothersome. Took 2 more tablets of 220mg naproxen sodium. Headache faded. 5/2/2021: mild headache and soreness persisted on and off until the evening.


VAERS ID: 1294826 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (drinks on weekend); Cigarette smoker (half pack per day)
Preexisting Conditions: Comments: Patient had no known drug allergies and did not had drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210509433

Write-up: BLURRED VISION TO RIGHT EYE; This spontaneous report received from a patient concerned a 53 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included alcohol user, and cigarette smoker, and other pre-existing medical conditions included patient had no known drug allergies and patient did not have drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 29-APR-2021 16:00 for prophylactic vaccination. No concomitant medications were reported. On 01-MAY-2021, the subject experienced blurred vision to right eye. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from blurred vision to right eye. This report was non-serious.


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